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Updated: Apr 13, 2026

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Partial PFO Closure for Persistent Hypoxemia in a Patient with Ebstein Anomaly.

S A Zuberi1, S Liu2, J W Tam2

  • 1Department of Internal Medicine, Faculty of Medicine, University of Manitoba, 409 Tache Avenue, Winnipeg, MB, Canada R2H 2A6.

Case Reports in Cardiology
|May 7, 2015
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Ebstein anomaly patients with severe tricuspid regurgitation and patent foramen ovale dependency may benefit from partial closure. Complete closure can cause decompensation, while partial closure improves hemodynamic stability and oxygenation.

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Area of Science:

  • Cardiology
  • Congenital Heart Disease

Background:

  • Ebstein anomaly involves tricuspid valve deformities and right ventricle atrialization.
  • Severe tricuspid regurgitation often necessitates tricuspid valve surgery and atrial septal defect closure.

Purpose of the Study:

  • To evaluate the impact of patent foramen ovale closure in a patient with Ebstein anomaly and severe hypoxemia.
  • To determine the optimal closure strategy for a patent foramen ovale in the context of Ebstein anomaly and right-to-left shunting.

Main Methods:

  • Case presentation of a 73-year-old female with Ebstein anomaly and severe hypoxemia.
  • Transthoracic echocardiography to assess tricuspid regurgitation and patent foramen ovale with right-to-left shunting.
  • Percutaneous closure of the patent foramen ovale, initially complete then partial.

Main Results:

  • Complete percutaneous patent foramen ovale closure resulted in acute decompensation.
  • Partial closure of the patent foramen ovale led to hemodynamic stability and improved oxygenation.
  • The patient demonstrated "patent foramen ovale dependency" due to longstanding shunts.

Conclusions:

  • Partial patent foramen ovale closure can be a beneficial strategy for selected Ebstein anomaly patients with "patent foramen ovale dependency".
  • Careful consideration of closure extent is crucial to avoid adverse events in patients with complex congenital heart disease.